Individual
KEITH THOMAS LONERGAN
Active
Individual
KEITH THOMAS LONERGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
30396
SC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
30396
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
576007863179
BCBS
SC
05
—
G51248
—
SC
01
—
P00607534
RR MEDICARE
SC
Enumeration date
01/30/2007
Last updated
11/10/2022
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